Stomach Sleepers
Sleeping on your stomach can be hard on your back. If you can’t sleep any other way, reduce the strain by placing a pillow under your pelvis and lower abdomen. Use a thin pillow under your head if it doesn’t place too much strain on your back. If it does cause strain, try sleeping without a pillow. (Mayo Foundation for Medical Education and Research)
Special mattresses are available with designs that help stomach sleepers get comfortable. These include mattresses with pressure-relief spots placed specifically for stomach sleepers. Generally, firmer mattresses are better.
For those on a budget, mattress toppers are also available with designs specific to stomach sleepers. Pillows specifically for stomach sleepers have been developed and are commercially available, using a variety of designs, including ultra-thin pillows, wedge pillows, contoured pillows, and adjustable pillows. (Proulx)
Back Sleepers
If you sleep on your back, place a pillow under your knees to help maintain the normal curve of your lower back. You might try a small, rolled towel under the small of your back or an inflatable cushion for lumbar support to help distribute pressure evenly between the pelvic, lumbar, and thoracic areas. (Normand 101)
Choose a pillow with sufficient neck support. It is recommended that the pillow fills the space between the mattress and your neck, but to do this, it requires a different pillow thickness than in side-lying. The pillow for side-lying needs to be thicker than when lying on your back. (Caldwell, n.d.)
While on your back, the pillow should also support your shoulders. (University of Utah, 2013) To keep a neutral spine, your neck should be aligned with your chest, as it is when standing.
Side Sleepers
If you sleep on your side, draw your legs up slightly toward your chest and put a thin pillow between your legs. If you turn over a lot, place a pillow on each side. Use a full-length body pillow if you prefer. Some side sleepers also find it comfortable to place a folded towel or thin pillow between their hips and ribcage.
Next time you are staying somewhere other than home—such as a hotel, Airbnb, or a friend’s house—pay attention to how your body feels the next day. Is your low back pain better, worse, or the same?
If better, take note of the firmness of that mattress versus your own. It might be time for a new one.
Research Suggests Medium-Firm Mattresses Help
Studies show a medium-firm mattress is generally best for people with low back pain. Below are direct quotes from published research:
“Medium-firm mattresses are beneficial for individuals with chronic nonspecific low back pain and were rated as more comfortable than soft bedding systems. Studies have shown that medium-firm mattresses improve sleep quality by 55% and decrease back pain by 48% in patients with chronic low back pain.” (Radwan 266)
“A mattress of medium firmness improves pain and disability among patients with chronic non-specific low back pain.” (Kovacs 1599)
“An inherent and unresolved issue centers around terms such as ‘firm’ and ‘soft,’ which are not globally defined either in the marketplace or in research. Yet, these data support both the benefit of a ‘medium-firm’ sleep surface constructed of layers of viscoelastic polyurethane foam and latex and the suitability of prescribing the sleep surface based on the prominent sleeping position.” (Jacobson 96)
“Putting these findings together, it would seem doctors should recommend mattresses that do not distort their patients’ spines, distribute weight evenly, and are medium firm in density.” (Harrison 2)
